The courts have long recognized the historical oppression of people experiencing mental illness or mental health disabilities.[1] In the Supreme Court of Canada case, R. v. Swain, Chief Justice Lamer wrote:
The mentally ill have historically been the subjects of abuse, neglect and discrimination in our society. The stigma of mental illness can be very damaging. The intervener, [Canadian Disability Rights Council], describes the historical treatment of the mentally ill as follows:
For centuries, persons with a mental disability have been systematically isolated, segregated from the mainstream of society, devalued, ridiculed, and excluded from participation in ordinary social and political processes.
The above description is, in my view, unfortunately accurate and appears to stem from an irrational fear of the mentally ill in our society.[2]
Mental health and addiction disabilities, such as schizophrenia, bipolar disorder, depression and alcohol addiction, have often been met with misunderstanding, ignorance and fear. Since the 1960s, consumer/survivor[3] groups and other organizations have worked to advance the civil rights of people involved with the psychiatric system and challenge these attitudes. Because of widespread negative stereotypes and lack of societal acceptance of these disabilities, people with mental health or addiction disabilities may face a complex set of difficulties when realizing and asserting their rights on a day-to-day basis.
All people with disabilities have the same rights to equal opportunities under the Code, whether their disabilities are visible or not. People with mental health issues and addictions are a diverse group, and experience disability, impairment and societal barriers in many different ways. Disabilities are often “invisible” and episodic, with people sometimes experiencing periods of wellness and periods of disability.
In addition to the Code, the Accessibility for Ontarians with Disabilities Act, 2005 (AODA) [4] addresses the right to equal opportunity and inclusion for people with disabilities. The AODA's goal is to make Ontario fully accessible by 2025. It introduces a series of standards (customer service, transportation, built environment, employment and information and communications) that public and private organizations must implement within certain timelines.
The AODA is an important piece of legislation that can improve accessibility in employment, services and in public life for people with disabilities. However, it can still be improved to fully reflect the spirit and requirements under the Code. For example, human rights principles must be taken into account to ensure that the AODA’s accessibility requirements include people with mental health issues.[5] To see more of the OHRC’s comments on the AODA standards, visit www.ohrc.on.ca.
Realizing people’s dignity, worth and self-determination on an equal basis with others is fundamental to advancing the human rights of people with mental health disabilities and addictions. These principles form a critical part of international human rights treaties such as the United Nations’ (UN) Convention on the Rights of Persons with Disabilities (CRPD – see section 1.6.3 for more details). Dignity and equality form the foundation of the Code. The challenge is to make sure legal rights and principles become a reality for people with mental health issues and addictions across Ontario.
2.1. Increasing awareness about disparities
At the provincial and federal levels, more attention is being paid to the adequacy and coordination of mental health and other support services. In 2003, the Standing Senate Committee on Social Affairs, Science and Technology (Senate Committee) held a nation-wide consultation. In 2006 it released “Out of the shadows at last” (the Kirby report), and in 2012, released the first national mental health strategy, with wide-reaching recommendations for mental health reform. In 2008, Ontario’s Minister of Health and Long-Term Care established an advisory group to develop a 10-year strategy to improve mental health and addiction services in Ontario. It released its mental health and addictions strategy in 2011.
In addition to a focus on service delivery, the federal and Ontario governments looked at the stigma and social exclusion that people with mental health disabilities and addictions face. Both levels of government have made mental health a priority, with the federal government establishing the Mental Health Commission of Canada and the Ontario government adopting a mental health and addictions strategy. Both levels of government committed to changing negative attitudes across multiple sectors, such as with youth and in health care.[6]
People are ready to have a conversation about mental health — but we’ve got a long way to go where biases and stereotypes about mental health and addictions are concerned. - Barbara Hall, Chief Commissioner, OHRC
[1] See Battlefords and District Co-operative Ltd. v. Gibbs, [1996] 3 S.C.R. 566; Fleming v. Reid, [1991] O.J. No. 1083, 1991 CanLII 2728 (ON CA) and Granovsky v. Canada (Minister of Employment and Immigration), 1 SCR 703 at para 68.
[2] R. v. Swain, [1991] 1 SCR 933 at p. 973-4.
[3] The term consumer/survivor refers to bridging at least two ideologies. Historically, the term “consumer” has been used to describe an approach to the psychiatric system that reflected choice and input into treatment and improving services, whereas the term “survivor” or “psychiatric survivor” has been adopted by people in the anti-psychiatry movement as a reaction to the concept of mental illness and wanting to replace psychiatry with survivor-run alternatives. Geoffrey Reaume, “Lunatic to patient to person: Nomenclature in psychiatric history and the influence of patients’ activism in North America” (2002) 25 Int. J. of Law and Psychiatry, 419-420. However, in using these terms, they may still apply to people who may have not sought help for mental health issues. Kathryn Church, Forbidden Narratives: Critical Autobiography as Social Science (New York: Gordon and Breach, 1995) at 12.
[4] S.O. 2005, c. 11.
[5] Letter from Chief Commissioner Barbara Hall to Charles Beer, AODA Review (October 30, 2009) regarding: Submission to the AODA review, online: Ontario Human Rights Commission www.ohrc.on.ca/en/resources/news/beer/view; In an independent review of the AODA in 2010, the reviewer, Charles Beer, heard from community stakeholders that the roll-out of the standards must be accompanied by substantial government investment to change the attitudinal barriers that limit opportunities for people with mental health and other disabilities. Charles Beer, Charting a Path Forward: Report of the Independent Review of the Accessibility for Ontarians with Disabilities Act, 2005 (2010), online: Ministry of Community Social Services www.mcss.gov.on.ca/documents/en/mcss/accessibility/Charles%20Beer/Charles%20Beer.pdf at 20.
[6] Part of the 10-year mandate of the Mental Health Commission of Canada is to develop a national mental health strategy and work to diminish the stigma and discrimination faced by Canadians living with a mental illness and their families. Final report of the Standing Senate Committee on Social Affairs, Science and Technology, Out of the Shadows at Last: Transforming Mental Health, Mental Illness and Addiction Services in Canada (2006) at 438 (Chair: Michael J.L. Kirby); In June 2011, the provincial government released its mental health and addictions strategy, which identified reducing stigma and discrimination as part of creating healthy, resilient and inclusive communities. Government of Ontario, Open Minds, Healthy Minds: Ontario’s Comprehensive Mental Health and Addictions Strategy (Toronto: Queen’s Printer for Ontario, June 2011) at 12.